Opportunities Missed

Republicans are good for one thing: handing opportunities over to Democrats. South Carolina Congressman Joe Wilson did it again last night: before a national audience watching President Obama address a joint session of Congress, he yelled out that Obama was a “liar” – at that point in Obama’s speech when he declared that he was not proposing health insurance for “illegal aliens.” Needless to say, Obama was telling the truth as any minimally informed Congressman should know; needless to say too, in this case as in others (for instance, when he declared that not one cent of federal money would go to pay for abortions), Obama’s “bipartisan” concessions are anything but estimable. Judging by the reaction of the corporate media, Wilson’s “incivility” was a boon to the Democrats; much as was the town hall blathering of “birthers” and “deathers” and “tenthers” and other unhinged morons, spurred on by Fox News and even less savory instruments of the GOP’s propaganda machine.

Democrats are good for one thing too: doing as little for the public good as they can with the opportunities that fall their way. Had Obama just said, from the beginning, that health care ought to be a right, not a commodity, and therefore that no one who doesn’t contribute to health care should profit from it, we’d now be on the point of joining the rest of the world in this regard. I’ve suggested before, and I continue to believe, that corporate opposition to a single-payer system would be no more intense than the opposition has been to Obama’s vague and not very coherent “guidelines” for reform, notwithstanding how much Obama’s reforms will do to “grow” the client base for private insurers, even if a “public option” survives the “sausage-making” now underway. But, following the lead of the Clintons before him and for reasons that are all too plain, Obama, along with the Pelosiite leadership of the House and Senate, ruled single-payer out of bounds from the get go.

In last night’s speech, Obama didn’t fold on the public option – not yet. He only said that it is one of several means to the end of providing affordable and universal (well, not quite universal) coverage. Thus he suggested that “the left” was wrong to fetishize the idea or, as the pundits say, “to draw a line in the sand” at that point. This was a skillful way to evade what is really going on in the “debate.” The right fears, and the (not-very) “left” hopes that a public option will be a Trojan Horse leading to a single-payer system. These fears and hopes are well-founded. If a public option is robust enough to be worth having, it will be attractive to almost everyone who is not a heavy investor in the insurance industry or a dogmatic free-marketeer. As John Edwards made clear in the early Democratic debates, a public option can be a way to back into the obvious solution. This is the hope and the fear that Obama, along with nearly everyone else in the political class and the corporate media, is intent on obfuscating.

It was interesting to see how Obama dealt with the obvious superiority of single-payer proposals last night. First, in good “centrist” fashion, he threw a sop to both the “left” and the “right” – saying that there are good arguments in favor of both single-payer systems and for relying on unregulated markets; in other words, good arguments in favor of the obvious solution but also in favor of the empirically and theoretically unsustainable convictions of free-marketeers. But then he said that, given how much of the American economy involves health care, it would be impractical to do anything other than build on and improve upon the system in place. This is a contention Obama makes whenever the issue arises. What he never does is support his claim with compelling arguments. The reason why is plain – a transition to a single-payer system is no more impractical than what Obama is proposing. What it is is detrimental to the interests of the health care profiteers (in the insurance, pharmaceutical and for-profit health care industries) who own the Republican Party outright and the Democratic Party nearly as completely.

I’m no expert, but I do know that there is nothing especially disruptive about people transitioning from private insurance to Medicare when they reach the age of 65. Here then, off the top of my head, is a way to make single-payer practical: beef up Medicare and then progressively lower the age for joining the system (going down from 65 to 55 would be a reasonable start); while making SCHIP an entitlement for all children (progressively raising the age for admissibility). Add to that the insurance reforms Obama is proposing for those in the middle and we would indeed be well on our way to where the rest of the developed world has been for more than half a century. If there really are fiscal concerns about going this route, then the steps up and down could be calibrated to take them into account. Meanwhile, one might think about the fiscal benefits of ending the hyper-costly Bush-Obama wars in Iraq and Afghanistan and rescinding the deficit-swelling tax cuts Republicans, along with many Democrats, gave to the super-rich in the early days of the Cheney-Bush administration.

No doubt, there are other, better ways, to get from here to there. Obama claimed last night that he was interested in hearing about “good ideas” and that his door is always open. At that point, it would have been salutary, though uncivil, for someone to yell out that he is a “liar.” For he is surely not interested in the thinking of the victims of the system in place or in hearing about ideas, no matter how compelling, that those who commodify health care oppose. If his door is open to anyone, it is to the bought and paid for legislators he is trying to woo and to the lobbyists of the interests they represent. For everyone outside this “bipartisan” consensus, the doors of power are, as always, firmly shut.